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DrG's Medisense Feature Article
12122-Prostate_Cancer_&_Substances
Prostate Cancer &
Chemical Substances
October 2011
Print Version
Prostate cancer is so common in late life, that it is hard to identify
causative carcinogens, dietary factors and
lifestyles. Being male is the strongest risk
factor, one which most men choose not to change. Which brings
us to…
Testosterone
stimulates growth of the prostate. This occurs with either a
man’s own testosterone or with pills, patch or cream
supplements. If early prostate cancer is present,
testosterone stimulates the cancer’s growth.
One of the primary prostate cancer treatments is to remove
testosterone, either by giving medication that blocks its production or
by removing the testicles. Therefore, men who have prostate
cancer should not take testosterone replacement therapy. It
is important for all men considering testosterone replacement therapy
to undergo prostate screening before starting this therapy.
Tobacco:
Once diagnosed with prostate cancer, men who smoke have a greater risk
of dying, compared to those who don’t. If prostate
cancer hits at least ten years after quitting smoking, outcome is
similar to those who have never smoked.
Food
carcinogens:
Nitrosamines, plentiful in charred red meat, promote prostate cancer
growth. Cadmium is a toxic heavy metal found in industrial
waste, tobacco and water, air, soil and food exposed to industrial
waste. Exposure increases risk of prostate cancer.
These toxins are more dangerous in men with certain genetic variants
that hamper the body’s ability to rid its self of toxins.
Alcohol:
Men who drink alcohol heavily and on a regular basis may be putting
themselves at increased risk for aggressive prostate cancer.
A number of studies confirm an association. In addition, the
Prostate Cancer Prevention Trial (PCPT) indicates that alcohol may
reverse any beneficial effect of finasteride (described below) in
preventing prostate cancer.
Vitamin
E: The
Alpha-Tocopherol (vitamin E), Beta-Carotene trial done in Finland
identified less prostate cancer in men who took vitamin E.
This led to the Selenium and Vitamin E Cancer Prevention Trial (SELECT)
to study the association further.
The study of 35,533 healthy, average-risk men older than age 50 years,
was stopped by the safety committee after 5.5 years.
Preliminary results, published in the Journal of the American Medical
Association in October, suggested that 400 IU of vitamin E daily
increased the number of prostate cancer cases and selenium increased
new diabetes diagnoses. Neither finding was statistically
significant, but there was enough concern to terminate the
trial. While the results can’t be construed to say
that vitamin E causes cancer, they certainly argue against vitamin E
protection.
Hints
at Chemical Prevention, but don’t bet your life on
them. Eating tomatoes, high in lutein
is associated with a less prostate cancer risk. Cooked
tomatoes are especially good, possibly because cooking releases the
lutein for better absorption into the body.
Other vitamins: Attempts to prevent prostate cancer with
vitamins haven’t been persuasively positive.
Vitamins C and D have variably helped or had no effect in prevention.
Testosterone
production blockers:
Five-alpha-reductase inhibitors (5-ARI) block testosterone
production. Two trials of 5-ARI treatment reduced prostate
cancer risk by about 6%. One, the PCPTrial, evaluated the
daily use of finasteride vs. placebo for 7 years, and the other, the
REDUCE trial, evaluated dutasteride vs. placebo for 4 years.
Each drug impacted only the rate of milder cancers.
The incidence of more severe cancers increased in both trials by
0.5-0.7%. Doctors don’t believe the drugs
themselves cause severe cancer. Instead, the drugs lower
prostate antigen (PSA) levels, which are used to detect
cancer. These artificially lowered PSA levels might lull
doctors into thinking that the prostate is normal, missing cancers
until they are more advanced. Any confirmed increase in PSA
during 5-ARI treatment may signal the presence of prostate cancer and
should be evaluated, even if that PSA level is in the “normal
range.” 5-ARIs are not approved for the prevention
of prostate cancer.
So, to prevent prostate cancer, eat your tomato soup and sauce, avoid
carcinogens, drink alcohol only in moderation and don’t
smoke.